I am a 69 yrs old male and have severe pain in the front of both legs. Pain in my lower the right is the worst. I also have pain in my lower back. No leg pain in back of my legs.

My doctor wants to do a disectomy(i thought it was fusion) from the l2 to the s1. I am really concerned mostly about the s1(sacrum) and how much it will effect body movement and recovery time. Did or does anyone have a similar surgery? Please reply thanks

Welcome to the board. My best recommendation, having had four lumber surgeries and being fused from L3 to S1, is to get several opinions, from both a neurosurgeon and an orthopedic spine surgeon, before agreeing to any surgery.

You don’t provide much information, but what you do report as your symptoms don’t jive with the recommended surgery. If you have pain in the front of the thighs, it is most likely coming from the L2 and L3 spinal nerves or stenosis in the central canal at these levels. The compression of spinal nerves below L3 causes pain in the back of the legs, buttocks and what people think is “hips.” Look for a “dermatome map” online to see which spinal nerves innervate which areas of the body. It gives you an idea of where to begin looking for a problem but is by no means exact.

It would be extremely unusual for a spine surgeon to perform discectomies on that many consecutive levels. It would create instability if a fusion were not performed at the same time. Also if there are that many bulging or herniated discs, I would assume there are other issues as well...things that would not be addressed by a discectomy alone.

In the lumbar spine, the segment that carries the most movement is at L4-5. By the time you get down to S1 there is almost no movement. Being fused at S1 isn’t noticeable to most who have it done. Sometimes it can create issues with the Sacroiliac (SI) joints though.

I have pain in both front legs, and numbness in both feet. This is . I have constant groin pain on my right side. I also have pain in my right buttocks which isn't constant. my neuro surgeon wants to fuse levels l2-s1. I don't know what to exspect . I don't want surgery on the s1. Its a lot more complicated. But he said without surgery I have 50 to 60% chance of success. With it 75%.

Numb feet is often a sign of nerve compression of primarily the L5 spinal nerves....which also affects the buttocks and groin, along with the S1 spinal nerves.

Again I would suggest you get several opinions before reaching a decision. This is a great generality, but in my experience and the experience of people I know who have had spinal surgery, neurosurgeons tend to do more levels than do orthopedic spine surgeons. They tend to want to do all levels that might cause a problem whereas orthos tend to try to do as little as possible that will still accomplish the goal.

Keep in mind with every additional level of fusion that is done beyond one level, chances for success go down. Anything beyond three consecutive levels...(like L3-S1, for example) is avoided unless absolutely necessary. If you are fused from L1 to S1 you will definitely notice loss of movement, bending and twisting in particular. It will put a great deal of stress on the level above (T12) and the level below (the SI joints) the fusion.

Also keep in mind that there will be a long period of recovery...you may show signs of bone growth within the first month, but it will take at least a year for the fusion to set up and for the bone growth to become strong. When I was fused from L3 to S1 it took about 16 months until I began to feel that my energy levels were back to ďnormalĒ and my body adjusted to its new structural alignment. Donít let anyone tell you you will only be laid up for a couple months. Recovery is long and requires a great deal of patience...and of course, there is no way to predict the outcome.

Only you can determine whether the possible benefits outweigh the risk of surgery and the possible unintended consequences. But I urge you to take your time in making a decision, to get at least another opinion to see if you have any options, etc.

I donít understand what you mean by ďwithout surgery I have 50-60% chance of success.Ē How would anything change if you do nothing?

Thanks teteri66. I am having surgery fri. The surgeon told me that if i have l2-l5 surgery i have a 50-60% of success. He is doing the l1-s1 fusion w/o cages the t12-l1 shows little signs of deterioration. I have collapsed,degenerated disc at l1-2,l3-4 and l4-5, and migrated disc fragments l5-s1 level. I was wondering about not having t.he l1 done and one doctor agreed .another just wanted to do l3-l5 fusion with cages another wanted to do the same but commented that this probably won't work.?? I just wanted to know about the effect of the l1 on movement. Thanks again.

I can't walk more than 100 ft. W/o severe leg pain. As soon as i stand up the pain starts. After a few minutes the severe pain makes me sits down . It'spainful laying down. I don't do much. Ireally want to cancal this surgery because i'm sick of all this pain. I just hope that i'm not creating more problems and pain. It's very tough doing this. I am concerned about not doing this. If i don't it probably only get worst. 2 days before surgery? Thanks again

Sorry...Iím traveling and havenít been checking into the board. I suppose you are going ahead with surgery tomorrow. Good luck. Iíll be available to answer questions as you recover. The important thing is to be patient and realize that recovery is a long slow process...and we arenít as young as we used to be!

My sciatic pain begin around 2004 but I noticed some numbness in my feet around 2000. My first surgery was in 2008...then 2009, 2010 and Sept 2017. (I donít know anyone who has had just one back surgery!). Before my first surgery I couldnít walk more than about 30í and couldnít stand long enough to chop an onion. I travel now and am very much improved...but not 100% ďback to normalĒ of course!

You asked about my situation and I didnít really answer you. I was traveling and not paying attention to the board at the time. I wanted to stress the reason I feel the need for really doing your homework and getting several opinions is rooted in my experiences since I had my first surgery in 2008. I have now had four lumbar surgeries, the most recent in Sept. 2017.

It is very important that you have confidence in your surgeon and a working relationship as well, as you may be seeing him/her more than originally thought!

My surgery is from the l2-s1. I didn't want the l2 done but i have constant pain in my upper thighs and was told it should done also. Does that sound right to you? I will find out my surgery date jan. 3rd. Have a happy new year.

Yes, it is the L2 and L3 spinal nerves that can cause a lot of pain across front of thighs. When I had surgery at L2-3, I had no thigh pain prior to surgery, but I sure woke up with it! I was quite miserable for about 9 months post surgery, but it did go away eventually. The L2 spinal nerve was stretched and molested during the surgery and it took that long to calm back down.

Glad to hear your doing good. My surgery is scheduled for 15jan. Iwould like to know how long after surgery you could sit/walk? Ialso forgot to mention that i have severe spinal stenosis. I have confidence in my surgeon. He c omes highly recommended. I can't help but to worry. I'm in between a rock and a hard place. I greatly appreciate your replys. Thanks again